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Mount Sinai Hospital Expansion, Toronto, Ontario

When Mount Sinai Hospital (MSH), a primary acute care facility recognized as one of the world’s top five cancer care and research hospitals needed to expand, the only way to go was up.


Client: Mount Sinai Hospital

Our client’s challenge

Built in 1973 in a prime downtown Toronto location, MSH had been designed to accommodate future additions. However, by the time the hospital needed to expand, the only available space was above the existing building.

To complicate the task, in the intervening years, the National Building Code had imposed more stringent requirements on the seismic design of structures, especially for post-disaster buildings.

A further challenge —and of utmost importance to MSH— was completing the expansion while maintaining full operations for what is not only a busy university hospital but also an internationally renowned medical research centre.

Our approach

The most common approach to seismic upgrade is to introduce new shear walls or frame systems throughout a building. However, operational restrictions on the amount of heavy construction allowed in the working hospital meant that only three new shear walls could be accommodated. 

To compensate for the increase in seismic load created by the proposed expansion, three existing elevator cores were selected to serve as the main seismic reinforcing elements. As well, advanced nonstandard modelling techniques and tools were used to measure the existing structure’s true seismic capacity, allowing an innovative lightweight system to be used to permit a six-storey addition.


“The engineers did an excellent job squeezing every ounce of available load capacity out of a 30 plus year-old hospital building. This allowed more new floors to be built on top of the existing hospital than originally thought possible,” said Vladislav Pavliuc, Vice President of HDR Architecture Associates, Inc., our partner in the Mount Sinai Hospital expansion.

The six-storey addition means a 40 per cent increase in space for The Frances Bloomberg Centre for Women’s and Infants’ Health: With almost 7,000 births per year, it is the largest academic obstetrical, gynaecological, and neonatal program in Canada. The 137,000-square foot space also includes

decentralized care stations, improving clinicians’ access to patients, and new rooms designed to take advantage of natural light.